Human Chorionic Gonadotropin
Common Name(s): HCG, Simeons diet, Simeons therapy
Medically reviewed by Drugs.com. Last updated on Dec 17, 2021.
Existing evidence does not support the use of human chorionic gonadotropin (hCG) in weight reduction, and the use of hCG for this purpose is not supported by the American Medical Association (AMA) or the American Society of Bariatric Physicians. Homeopathic preparations of hCG do not contain significant amount of the active ingredient, and clinical trials have not been conducted to provide evidence for effect. hCG is a one of the most common ancillary substances used by anabolic-androgenic steroid (AAS) users to not only enhance muscle/strength during stacking but to also reduce depressive symptoms upon AAS withdrawal.
Recommendations for dosing for indications other than those approved for hCG cannot be made because evidence to support efficacy is lacking.
Precocious puberty, prostatic carcinoma or other androgen-dependent neoplasia, prior allergic reaction to chorionic gonadotropin, and pregnancy.
hCG is contraindicated in pregnant women. Avoid use in lactation.
None well documented.
Arterial thromboembolism, headache, irritability and other CNS symptoms, genitourinary effects, and hypersensitivity have been reported.
Defects of forelimbs and the CNS, as well as alterations in sex ratio, have been reported in mice on combined gonadotropin and hCG regimens. No mutagenic effect has been clearly established in humans.
hCG is prepared from the urine of pregnant women. It can also be produced via recombinant DNA/genetic modification techniques.hCG 2005
In the 1950s, the endocrinologist Dr. Albert Simeons promoted the use of hCG together with an ultra-low calorie diet (500 calories per day) as a weight loss strategy in which the body would preferentially burn stored fat from the stomach, hips, and thighs without causing undesirable loss of muscle tissue, hunger, or irritability.
Following the publication of trials refuting its efficacy and including adverse events, the use of hCG fell out of favor. In 1995 the US Food and Drug Administration required labeling and advertising of hCG to state that there was no evidence of efficacy in weight reduction. Homeopathic drops and lozenges containing the "energetic imprint" of hCG have been promoted via the Internet.Robb-Nicholson 2010, Hamilton 2004
hCG is a water soluble glycoprotein hormone derived from the urine of pregnant women. It is produced by the developing embryo after conception and later by the placenta.hCG 2005
Uses and Pharmacology
The action of hCG is virtually identical to that of pituitary luteinizing hormone, although hCG appears to have a small degree of follicle-stimulating hormone activity as well. It stimulates production of gonadal steroid hormones by stimulating the testis to produce androgens and the corpus luteum of the ovary to produce progesterone.(hCG 2005) Approved indications for the use of hCG are prepubertal cryptorchidism, hypogonadism, and ovulation induction. However, hCG is commonly used as an ancillary substance by AAS users for its anabolic effects and for managing AAS withdrawal symptoms.(Sagoe 2015)
Anabolic steroid use
hCG has been identified in a systematic review as one of the 10 most common ancillary substances used by AAS users. Across a total of 17 studies (ie, interviews, questionnaires, cases) that included 1,258 AAS users, hCG was often used to supplement "stacking" during AAS "on cycles" in order to improve testosterone production and enhance muscle/strength as well as prevent weight loss and testicular atrophy. Upon AAS cessation, hCG was used to minimize withdrawal symptoms such as depressive symptoms. Users included legal offenders, male and female weightlifters/bodybuilders, IV drug users, and footballers across a variety of settings (ie, police stations, gymnasiums, syringe exchange centers, online forums, prison, supplement shops, sports shops and associations).(Sagoe 2015)
Strong anti-inflammatory effects and reduced mortality have been demonstrated by an hCG beta-chain derived peptide (EA-230) in preclinical and clinical models of systemic inflammatory disease.(van Groenendael 2019)
In vitro fertilization
Adjunctive use of low-dose hCG (200 units/day) to a gonadotropin releasing hormone antagonist protocol in women undergoing in vitro fertilization/intracytoplasmic sperm injection, failed to produce any significant difference in rates of pregnancy, fertilization, implantation, or ongoing pregnancy in a randomized controlled trial (n=137).(Aghahosseini 2014)
hCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity, and it is the position of the American Society of Bariatric Physicians that hCG cannot be recommended for weight loss.(4)
A meta-analysis of clinical trials conducted up to 1995 found no evidence of effect for hCG in weight loss, redistribution of fat, or sense of hunger or well-being, beyond that resulting from caloric restriction.(Lijesen 1995) There have been no published quality clinical trials since the meta-analysis, and no clinical trials have been published using either homeopathic drops or lozenges.(Hamilton 2004)
Recurrent spontaneous abortion
In a systematic review and meta-analysis of randomized controlled trials evaluating treatment for recurrent spontaneous abortion, subgroup analysis revealed hCG was not as effective as dydrogesterone. Dydrogesterone led to a higher pregnancy success rate than hCG alone (odds ratio [OR]=6.25; 95% confidence interval [CI], 2.41 to 16.2; P=0.000; 2 studies, N=172) or when hCG was combined with progesterone (OR=5.87; 95% CI, 2.45 to 14.03; P=0.000; 3 studies, N=267). The dydrogesterone group also had significantly fewer adverse effects than those who received hCG alone or in combination with progesterone (P=0.000 for each). Heterogeneity was not significant among studies for any of these outcomes.(Guo 2021)
Recommendations for dosing for indications other than those approved for hCG cannot be made as evidence to support efficacy is lacking. Trials used 125 units of hCG daily for 6 days out of 7 over a 6-week period for weight reduction.Lijesen 1995, Young 1976
Homeopathic forms of hCG do not contain sufficient quantities of the active ingredient, and the efficacy of the "energetic imprint" has not been substantiated.ASBP 2009
Bioavailability of the injection is greater with intravenous delivery than with subcutaneous delivery.Chan 2003
Pregnancy / Lactation
Category X. hCG is contraindicated in pregnant women.hCG 2005
It is not known whether chorionic gonadotropin is excreted in human milk.hCG 2005
None well documented.
Known adverse reactions include arterial thromboembolism, CNS symptoms (eg, headache, irritability, restlessness, depression, fatigue, aggressive behavior), and genitourinary and hypersensitivity effects, as well as local effects from the injection (eg, pain, edema).(hCG 2005) A case of Mycobacterium cutaneous infection following subcutaneous self-injection of hCG with syringes obtained from a private weight loss clinic was reported in a 51-year-old female with a history of hypogammaglobulinemia.(Neill 2017)
The transmission of hepatitis that was historically associated with the use of jet injectors in clinics was resolved by use of single-use disposable syringes.(Canter 1990, MMWR 1986)
Defects of forelimbs and the CNS, as well as alterations in sex ratio, have been reported in mice on combined gonadotropin and hCG regimens. The dose of gonadotropins used was intended to induce superovulation. No mutagenic effect has been clearly established in humans.hCG 2005
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